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Comprehensive health literacy assessment for college students

Date

2013

Authors

Harper, Raquel, author
Trumbo, Craig, advisor
O'Keefe, Garrett, committee member
Zimmerman, Donald, committee member
Henry, Kimberly, committee member
Broadfoot, Kirsten, committee member

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Abstract

This study presents the content of a new health literacy assessment tool tailored specifically for the 18-24 year-old college student population. The new tool encompasses a more comprehensive measurement of comprehension, numeracy, media literacy, and digital literacy. The current leading health literacy assessment tools do not assess the entire concept of patient health literacy, have limited empirical evidence of construct validity, are lacking in their psychometric properties, and are not targeted specifically for the young adult population. Research shows that many higher educated individuals are currently graduating without the necessary skills needed to adequately and efficiently navigate the healthcare system. Poor patient health literacy may be an even stronger predictor of a person's health status than age, income, employment status, education level, and race (Institute of Medicine, 2004). The author created an initial item pool of 229 questions based on research. Health education experts reviewed the initial item pool and helped select the best items that might represent the sub-components of health literacy. This first version of the test was administered to 144 college students. Item Response Theory analysis helped eliminate non-performing items. A second version of the test was administered to 426 college students and analyzed again using Item Response Theory. The new assessment tool was also compared with the current gold standard health literacy tool to establish construct validity, and the two tools were compared for how well each predicts certain health behaviors. Fifty-one items were selected for the assessment based on good psychometric properties. The final version has good internal consistency (Cronbach's alpha = 0.81). Convergent validity and discriminant validity were supported with expected sub-component correlations with the gold standard tool. And the new assessment tool shows better predictive validity with health-related quality of life, exercise frequency, overall participation in physical activities, and alcohol consumption over the current gold standard tool. The new instrument is recommended for research use in measuring health literacy in young adult populations, especially college students, to help identify deficiencies and strengths in the sub-concepts of health literacy.

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